焦虑障碍患者的注意偏向和自我注意特点(综述)

有关焦虑障碍的认知模式的研究近年来颇为引人瞩目，其研究方法和研究成果对临床实践工作也产生了积极的影响。本文将重点介绍注意偏向（aaentional bias）和自我注意（selGfocused attention）方面的研究，评析相应研究成果在心理咨询工作中的价值和意义，探讨实验研究与临床工作的关系。     

Endogenous Superantigens Shape Response to Exogenous Superantigens

Endogenous superantigen-mediated thymic negative selection resulted in a paucity of mature T cells bearing T-cell receptor (TCR) Vβ8 in the periphery. Consequently, the magnitude of immune response to exogenous superantigen staphylococcal enterotoxin B, which activates TCR Vβ8⁺ T cells, was significantly reduced and conferred protection from superantigen-induced mortality.     

Ambient Light Modulation of Exogenous Attention to Threat

Planet Earth’s motion yields a 50 % day–50 % night yearly balance in every latitude or longitude, so survival must be guaranteed in very different light conditions in many species, including human. Cone- and rod-dominant vision, respectively specialized in light and darkness, present several processing differences, which are—at least partially—reflected in event-related potentials (ERPs). The present experiment aimed at characterizing exogenous attention to threatening (spiders) and neutral (wheels) distractors in two environmental light conditions, low mesopic (L, 0.03 lx) and high mesopic (H, 6.5 lx), yielding a differential photoreceptor activity balance: rod > cone and rod < cone, respectively. These distractors were presented in the lower visual hemifield while the 40 participants were involved in a digit categorization task. Stimuli, both targets (digits) and distractors, were exactly the same in L and H. Both ERPs and behavioral performance in the task were recorded. Enhanced attentional capture by salient distractors was observed regardless of ambient light level. However, ERPs showed a differential pattern as a function of ambient light. Thus, significantly enhanced amplitude to salient distractors was observed in posterior P1 and early anterior P2 (P2a) only during the H context, in late P2a during the L context, and in occipital P3 during both H and L contexts. In other words, while exogenous attention to threat was equally efficient in light and darkness, cone-dominant exogenous attention was faster than rod-dominant, in line with previous data indicating slower processing times for rod- than for cone-dominant vision.     

Association between a Synaptosomal Protein (SNAP-25) Gene Polymorphism and Verbal Memory and Attention in Patients with Endogenous Psychoses and Mentally Healthy Subjects

Synaptosomal protein SNAP-25 is involved in the process of transmitting nerve spikes in the CNS and in the consolidation of memory traces in the hippocampus. Two independent studies have demonstrated associations between SNAP-25 gene polymorphisms and intellectual functions in a group of mentally healthy subjects and patients with schizophrenia. The aim of the present work was to perform a comparative study of the association between the MnlI polymorphism of SNAP-25 and cognitive functions (verbal memory, attention/executive functions) in 66 patients with endogenous psychoses, 75 of their mentally healthy relatives, and 136 healthy control subjects. Statistical analysis showed that the effectiveness of performing cognitive tests was significantly affected by group assignment (p = 0.00001) and genotype (p = 0.012). The interaction between genotype and group assignment also had an influence (p = 0.02). In all groups, carriers of the TT genotype had worse measures than carriers of other genotypes. The similar nature of the influences of the MnlI polymorphism on variations in measures in all groups indicates that this gene is related to overall intellect.     

Antagonistic Effects of Endogenous and Exogenous Tgf-$sZ and Tnf on Auto-immune Diseases in Mice

Injection of transforming growth factor $sZ₁ (TGF-$sZ₁) for five days during the late phase of the immunization process leading either to collagen type II induced arthritis (CIA) or to experimental allergic encephalomyelitis (EAE) protects against the development of these auto-immune diseases. Tumor necrosis factor a (TNF-$aL) injected during this same interval aggrevates CIA. In addition, anti-TGF-$sZ exacerbates and anti-TNF protects against CIA, acute and relapsing EAE, suggesting an important regulatory role for the endogenous production of the two cytokines on the severity of these diseases. More detailed studies about the mechanism of action of TGF-$sZ in acute EAE show that there is no detectable effect of TGF-$sZ on the development of sensitized T cells in vivo, as assayed by the proliferative responses of T cells from lymph nodes and peripheral blood to myelin antigens. Nevertheless, the number of lymphoid cells infiltrating the central nervous tissue is much greater in untreated than in TGF-$sZ-treated, protected mice. We conclude that it is likely that TGF-$sZ protects against experimental auto-immune diseases by interfering with the entry of lymphoid cells into the target organs through inhibition of the upregulation of adhesion molecule expression on endothelial cells, and with subsequent inflammatory processes inside the target organs by antagonizing both the production and the effects of TNF.     

Antagonistic Effects of Endogenous and Exogenous Tgf-$sZ and Tnf on Auto-immune Diseases in Mice

Abstract

Injection of transforming growth factor $sZ₁ (TGF-$sZ₁) for five days during the late phase of the immunization process leading either to collagen type II induced arthritis (CIA) or to experimental allergic encephalomyelitis (EAE) protects against the development of these auto-immune diseases. Tumor necrosis factor a (TNF-$aL) injected during this same interval aggrevates CIA. In addition, anti-TGF-$sZ exacerbates and anti-TNF protects against CIA, acute and relapsing EAE, suggesting an important regulatory role for the endogenous production of the two cytokines on the severity of these diseases. More detailed studies about the mechanism of action of TGF-$sZ in acute EAE show that there is no detectable effect of TGF-$sZ on the development of sensitized T cells in vivo, as assayed by the proliferative responses of T cells from lymph nodes and peripheral blood to myelin antigens. Nevertheless, the number of lymphoid cells infiltrating the central nervous tissue is much greater in untreated than in TGF-$sZ-treated, protected mice. We conclude that it is likely that TGF-$sZ protects against experimental auto-immune diseases by interfering with the entry of lymphoid cells into the target organs through inhibition of the upregulation of adhesion molecule expression on endothelial cells, and with subsequent inflammatory processes inside the target organs by antagonizing both the production and the effects of TNF.     

Role of Endogenous and Exogenous Nitric Oxide on Intestinal Mucosa and Microflora in the Rat

In the present study the effects of exogenous and endogenous nitric oxide (NO) on intestinal bacteria and on the intestinal tissue integrity have been investigated in healthy rats and in rats receiving bacterial endotoxin (LPS). A segment of jejunum was taken in order to evaluate tissue damage and hematoxylin-eosin staining; microbiological studies were carried out collecting stool samples. Administration of LPS (5 mg kg^–1 i.v.) induced a moderate jejunal damage, which was completely prevented by N^G-nitro-L-arginine methyl ester (L-NAME, 5 mg kg^–1 s.c.), thus suggesting a damage of endogenous NO on the intestinal mucosa; sodium nitroprusside (SNP, 10 mg kg^–1 os) reduced significantly jejunal damage induced by LPS. Endogenous NO produced by the administration of LPS resulted to be cytotoxic for all examined aerobic and anaerobic bacteria, while exogenous NO, released from SNP, showed an inhibitory effect only on Entero. faecalis and E. coli growth. From our data, it seems reasonable to conclude that high local levels of NO are required in order to observe jejunal damage and cytotoxic effects on aerobic and anaerobic faecal flora.     

血压的多频率生物节律特性及其受内外因素作用变化的机制探讨

本文旨在探索生物节律的起源,内外因素对生物节律的影响机制。从新生儿到老人(共245人)着手,连续24小时以上检测其血压,其中68人被连续检测七日以上。采用Halberg等的余弦法对上述血压的时序数据作24,168小时为周期的余弦曲线拟合,所获得的振幅作相关和回归分析。还分别对24,168小时以上的时序数据作最佳拟合。其结果是近日节律的节律性随年龄增大而增强;近七日节律随年龄增大而减弱。在新生儿中,近日节律的最佳拟合周期很少有24小时,而其他年龄组几乎均在24小时,近七日节律,新生儿最佳拟合周期远离168小时,其他人非常接近168小时。结论是:近日节律和近七日节律是内源性的,但是它们不一定是24小时和168小时,在外界环境的刺激和影响下,内在节律与外环境节律发生整合,结果使内在节律调整得更接近于外环境节律。     

Dynamics of Cognitive Anomalies in Patients with First Episodes of Juvenile Endogenous Psychosis

The therapeutic dynamics of neuropsychological and neurophysiological markers of impairments to cognitive functions were studied in groups of patients with first episodes of juvenile endogenous psychosis (90 patients). At the initial stage of remission, subjects were found to show improvements in processes associated with voluntary regulation of cognitive functions (due to the activity of extensive networks of cortical and subcortical structures), while more automatic processes (associated mainly with the temporal areas of the brain) remained abnormal. Changes in neurocognitive anomalies during the onset of remission were also identified in groups of patients in whom episodes had different syndromal structures – catatonic, hallucinatory-delusional, and affective-delusional.     

The Allogeneic Effect Revisited: Exogenous Help for Endogenous,Tumor-Specific T Cells

The “allogeneic effect” refers to the induction of host B cell antibody synthesis or host T cell cytotoxicity, including tumoricidal activity, by an infusion of allogeneic lymphocytes. We show that treatment of mice with cyclophosphamide (Cy) followed by CD8⁺ T cell-depleted allogeneic donor lymphocyte infusion (Cy + CD8⁻ DLI) induces regression of established tumors with minimal toxicity in models of both hematologic and solid cancers, even though the donor cells are eventually rejected by the host immune system. The optimal antitumor effect of Cy + CD8⁻ DLI required the presence of donor CD4⁺ T cells, host CD8⁺ T cells, and alloantigen expression by normal host but not tumor tissue. The results support a model in which a donor CD4⁺ T cell-mediated graft-versus-host (GVH) reaction effectively awakens antitumor immunity among Cy-resistant host CD8⁺ T cells. These events provide the cellular mechanism of the “allogeneic effect” in antitumor immunity. Cy + CD8⁻ DLI may be an effective and minimally toxic strategy for awakening the host immune response to advanced cancers.     

乳头丘脑束损伤对大鼠内源性注意的影响

目的:了解外源性注意和内源性注意是否可以分离?内源性注意与哪些生理位置相关?方法:用机械毁损法毁损大鼠双侧MT,观察大鼠行为和注意能力变化。同时,电击被毁损后大鼠右侧VTA,用免疫组织化学法,采取同脑左右对比,观察大鼠相关脑区的c-fos表达,了解在毁损发生后信息的传导情况。结果:大鼠在双侧MT被机械毁损之后,3天里持续的注意能力变化与麻醉时基本相同,内源性注意完全消失;强烈的痛刺激有反应,角膜、吞咽反射存在、外源性注意存在,且这种状态呈现出不可恢复的形势。未毁损MT时,电击右侧VTA,同脑左右侧表现出有显著差异的c-fos表达;毁损双侧MT后电击右侧VTA,同脑左右侧c-fos表达基本上无差异。结论:毁损MT大鼠内源性注意消失,外源性注意依然存在,外源性注意和内源性注意可以分离。从c-fos表达上可以看出,毁损MT后电击信号没有传入大鼠脑的相应部位,这可能是导致大鼠内源性注意消失的主要原因,由此推知双侧MT是大鼠内源性注意通路上的关键位置。     

MRI Morphometry of the Cerebral Ventricles in Patients with Attention Deficit Hyperactivity Disorder

A total of 27 right-handed patients aged 7–30 years with diagnoses of attention deficit hyperactivity disorder were studied using standard MRI scans. Of these, 14 were aged below 13 years. The volumes of the lateral ventricles were measured using T1-weighted MRI images of sagittal sections of the brain to a precision of 3 mm3. External head sizes were also measured to allow ventricle volumes to be normalized. All patients underwent complex neuropsychological investigations. Memory was assessed, along with visual, auditory, tactile, and spatial recognition functions and the motor and speech spheres. Test data were assessed in terms of the severity of impairments associated with one brain structure or another on a tenpoint scale. Assessment points were summed for each hemisphere, for the “first area” (cortical structures), and all structures for statistical analysis. Neuropsychological testing revealed functional impairments predominantly of the frontal areas of the hemispheres, the hippocampus, and the reticular formation. Neuropsychological deficits were least linked with alterations in the postcentral and parietal areas of the cortex. Statistical analysis demonstrated a significant positive correlation between the normalized left lateral ventricle volume and the degree of neuropsychological impairments (r = 0.5127 at p = 0.0063) for the whole study group. The correlation was more marked on comparison of the normalized left ventricular volume and the severity of neuropsychological impairments related to the left hemisphere (r = 0.6303 at p = 0.0004). A relationship was seen between the volume of the intraventricular space and cortical functional impairments (r = 0.5071 at p = 0.0069) in patients less than 13 years old. A relationship between ventricular volume and linear head size was confirmed (r = 0.5759 at p = 0.0017), which was more marked in subjects less than 13 years old (r = 0.6833 at p = 0.01).     

Assays for Endogenous and Exogenous Lymphoid Leukosis Viruses and Chick Helper Factor with RSV(−) Cell Lines

Japanese quail cells transformed by the envelope-defective Bryan high-titer strain of Rous sarcoma virus [R(-)Q] were used as a source of the Rous sarcoma virus genome in three kinds of assays. (i) The simplest and most sensitive assay for infectious, endogenous viruses of the chicken belonging to subgroup E involved infection of a mixture of R(-)Q cells and turkey cells with the sample and assay of supernatants of these cells for focus formation on subgroup E susceptible cells. (ii) Inactivated Sendai virus-induced fusion of R(-)Q cells with live test cells was found to be a specific method for detection of chick helper factor. Focus formation by supernatant of the fused cells on subgroup E susceptible cells was correlated with the presence of subgroup E envelope glycoprotein on the plasma membranes of test cells. Whole blood cells as well as fibroblasts could be used in this assay. (iii) A method of assay for exogenous lymphoid leukosis viruses in which mixed cultures of R(-)Q cells and C/E cells and assay of supernatants for focus formation on C/E cells was as sensitive as assays presently used for exogenous lymphoid leukosis virus. Because no infectious Rous sarcoma virus was used as part of the procedure, the assays for infectious virus described here yielded pure pseudotypes of the input virus, an advantage for determining purity and subgroup of the input virus.     

基于ICA的颞叶癫痫背侧注意网络的研究

很多fMRI研究表明部分癫痫患者缺省模式网络存在中断现象,而对于颞叶癫痫背侧注意网络的研究几乎没有涉及。本研究尝试运用独立成分分析(independent component analysis,ICA)分离出16例单侧颞叶癫痫(temporal lobe epilepsy,TLE)患者和20例正常对照的背侧注意网络,并采用拟合度值(goodness-of-fit scores)分析对感兴趣成分进行挑选,将其结果进行组内分析和组间分析。结果表明:背侧注意网络分布于双侧顶内沟、额中回、额眼区、右侧小脑后叶等区域;颞叶癫痫患者的背侧注意网络相比正常人,大部分区域功能连接度下降,以双侧顶内沟、额中回、右侧小脑后叶区域显著,这可能是由于颞叶癫痫患者的大脑功能内源性组织发生破坏。拟合度值下降表明背侧注意网络激活区域为单侧TLE患者提供了一个灵敏的生物信号特征。     

Defective Serotonin (5-HT) Transport Mechanism in Platelets from Patients with Endogenous and Allergic Asthma

The kinetics of the 5-HT-uptake by platelets in platelet-rich plasma (PRP) and PRP diluted with autologous platelet-poor plasma (PRP/PPP) were determined in normal subjects, patients with asymptomatic exogenous asthma and those with symptomatic endogenous asthma.
In normal subjects the 5-HT-uptake by platelets strictly obeyed Michaelis-Menten's kinetics. In patients with asymptomatic exogenous asthma, the active 5-HT-transport was moderately distorted in PRP and severely altered in PRP/PPP. Patients with symptomatic endogenous asthma exhibited already in PRP a dramatic transport disturbance.
The alteration of the active 5-HT-transport was characterized by increasing uptake inhibition by rising 5-HT concentrations in plasma. This phenomenon could be due to changes in the platelet environment, defects in the platelet membrane or intrinsic platelet disorders. It is concluded that asthmatics have a genetically or later acquired platelet disorder, which is more clearly observed in patients with symptomatic endogenous asthma than in those with asymptomatic exogenous asthma.     

Comparison of Linear and Quadratic Classification of Event-Related Potentials on the Basis of Their Exogenous or Endogenous Components

The linear and quadratic techniques for classifying exogenous and endogenous components of event-related potentials are compared. The test and train on the same data, test and train on different data, and the leave-one-out techniques of evaluating classifier performance are employed. Time samples from waveforms measured from four electrodes simultaneously were used to design the classifiers. Classification results utilizing both techniques gave comparable accuracies suggesting that differences in the data covariances were not significant for the test conditions occurring in each paradigm.     

Brain Reactivity and Selective Attention to Sleep-Related Words in Patients With Chronic Insomnia

Objective/Background: Sleep-related attentional bias has been suggested to represent an important factor for the maintenance of chronic insomnia. However, little is known about potentially underlying psychological mechanisms such as threat or craving. As these are associated with distinguishable brain activation patterns, we performed a functional neuroimaging study. Participants/Methods: Functional magnetic resonance imaging was used to investigate brain reactivity to sleep-related words in 20 patients with primary insomnia according to DSM-IV criteria and 35 good sleeper controls according to Research Diagnostic Criteria. In addition, an emotional Stroop task was performed in all participants outside the scanner to investigate sleep-related attentional bias. Results: Contrary to the hypotheses, patients with chronic insomnia did not differ from good sleeper controls in terms of threat- or craving-related brain reactivity to sleep-related words. In addition, the emotional Stroop task did not reveal any significant group difference in sleep-related attentional bias. Exploratory analyses did not show any significant correlations between brain reactivity/selective attention to sleep-related words and questionnaire scores/PSG parameters. Conclusions: The results from the present study call into question that attentional bias to sleep-related stimuli is a core feature of chronic insomnia. Future studies may use pictorial stimuli and larger sample sizes for investigating sleep-related information processing in insomnia.     

Effect of Artrofoon on Parameters of Endogenous Intoxication and Activity of Myeloperoxidase in Leukocytes from Patients with Postoperative Peritonitis

We studied the possibility of using artrofoon in the treatment of patients with localized suppurative postoperative appendicular peritonitis. A significant inhibiting effect of the preparation on endogenous intoxication parameters was demonstrated. Inhibition of myeloperoxidase hyperactivity is considered as a possible mechanism of the therapeutic effect of artrofoon as a component of complex therapy.